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Some things in life can’t be controlled, only understood. We can’t control the weather, but we can understand storms well enough to save lives. We can’t control whether a conception survives, but we can understand that many don’t, and we can treat the women it happens to. An estimated 10 to 20 percent of pregnancies end in early miscarriage, more than a million cases a year in the United States. No law changes that number. The only things a law can change are whether we learn from it and how well we treat the people it happens to.
Laws that restrict abortion are written as if outcomes could be controlled by banning a procedure. But the procedures and medicines at stake are the same ones used for pregnancy loss. The medications used to treat miscarriage, mifepristone and misoprostol, are the same ones used for a medication abortion, and surgical evacuation of the uterus is used in both situations. One specialist noted that managing a miscarriage takes the same skills as providing abortions. You cannot ban one without affecting the other.
The evidence that this causes harm is now accumulating. One survey found that fewer than half of residency programs offered mifepristone for miscarriage, and that availability fell as abortion restrictions rose. Researchers found that institutional restrictions mattered more than state law or religious affiliation in determining whether evidence-based miscarriage treatments were offered. That matters because the American College of Obstetricians and Gynecologists (ACOG) recommends surgical aspiration and medication treatment with both mifepristone and misoprostol as the safest, most effective options. Treating a miscarriage without mifepristone is more likely to fail and to require an unscheduled procedure.
A study in the Journal of the American Medical Association (JAMA) published in 2026 found the same pattern nearly four years after Dobbs. States with abortion bans saw a shift away from medication management and toward expectant management, in which a person simply waits for the miscarriage to resolve. Among patients who did receive medication, misoprostol-only regimens increased in ban states compared with the combination. The shifts in that study are modest. But they point the same direction as the individual cases, which is that standard care is eroding.
The pattern is hardest to see in the cases where the pregnancy cannot continue. When severe or fatal fetal anomalies are detected, people in states with bans may not have the option to end the pregnancy. All state bans have exceptions for life endangerment, but those exceptions don’t cover the wide range of circumstances people face during a pregnancy loss. KFF, formerly the Kaiser Family Foundation, documented women with imminent fetal demise or early pregnancy loss who couldn’t get treatment until their health declined to the point where their lives were at risk. That is the cost of trying to control an outcome instead of understanding it. A rule written to stop one thing keeps doctors from treating another.
It also lands unequally. Black women are more likely to experience miscarriage and stillbirth than white women. Fetal personhood laws can deter some pregnant people, particularly some people of color, from seeking care during a pregnancy loss because a miscarriage may be mistaken for a self-managed abortion. When a woman fears being treated as a suspect, she waits, and waiting is where complications grow.
Meanwhile, abortion is not a rare or exotic corner of medicine. Guttmacher estimates that about one in four US women will have an abortion by age 45. That means almost everyone, including abortion opponents, knows someone who has had one. ACOG has called safe, legal abortion a necessary component of women’s health care, and has urged hospitals to support it as essential medical care. The World Health Organization calls abortion a safe, non-complex health-care intervention. Opponents dispute this. An anti-abortion doctors’ group argues that ACOG’s positions don’t reflect the views of many in the medical community. But the major medical organizations that treat pregnant women every day have said the same thing for years.
If a society truly wanted fewer pregnancy losses and fewer abortions, it would do what it does with any health problem it can’t control. It would fund research into why conceptions fail. It would collect honest data. It would train doctors in every evidence-based option and protect them when they use it. It would make contraception, prenatal care, and follow-up care easy to get. None of that requires anyone to claim they can control what happens inside a woman’s body.
What we can do is understand it. We can offer a woman the full range of care and trust her to decide with her doctor. When laws substitute control for understanding, the results show up in hospital hallways, in infections that spread, and in women who die from avoidable complications.
